Provider Demographics
NPI:1225239833
Name:GOBER, GEORGE RAY (RPH)
Entity Type:Individual
Prefix:MR
First Name:GEORGE
Middle Name:RAY
Last Name:GOBER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:654 COUNTRY CT
Mailing Address - Street 2:
Mailing Address - City:BARTONVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76226-2605
Mailing Address - Country:US
Mailing Address - Phone:817-430-8962
Mailing Address - Fax:
Practice Address - Street 1:654 COUNTRY CT
Practice Address - Street 2:
Practice Address - City:BARTONVILLE
Practice Address - State:TX
Practice Address - Zip Code:76226-2605
Practice Address - Country:US
Practice Address - Phone:817-430-8962
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19914183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist